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Last lesson, we looked at natural disasters and focused on two specific storms t
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Last lesson, we looked at natural disasters and focused on two specific storms to study how lessons are learned and applied. As we saw, there were some important lessons from Katrina that saved lives during Sandy. Here, we are going to take a closer look at Katrina. Read the article “The Deadly Choices at Memorial (Links to an external site.)” by Dr. Sheri Fink and discuss your thoughts. What did you find most shocking? Did you agree with the choices being made in the hospital or not? There is a lot of info contained in this paper so don’t feel constrained to these questions if you’d like to comment on another specific aspect of the article. Please make a primary post of at least 500 words explaining your choice no later than 259AM ET Friday. Reply to at least 2 of your classmates with posts of at least 350 words no later than 259AM ET Monday.
**If you would like to read more on this topic, Dr. Fink went on to write a book based on her experiences at Memorial called “Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital (Links to an external site.)
***There will be a number of opportunities to participate in discussion areas during the course of this semester. As you will find, your classmates are a wealth of knowledge and we can learn a lot from each other. The 2 replies is the minimum requirement but I encourage you to post more replies and to have some good conversations with me and your classmates.
***As we are working through these discussion areas, please remember that this is an academic discussion designed to advance our knowledge and understanding. When you are replying to your classmates, don’t just agree with their idea. Ask questions, expand on their points, and offer opposing views. It is perfectly acceptable to have differing opinions but please remember to focus any critiques on the idea instead of on your classmate.
These are the two posts I would like a reply to:
This article was a rollercoaster of emotions as I continued to read and learn more about the events that unfolded. I found myself constantly thinking “well surely it can’t get any worse… right?” but then it did and I cannot possibly fathom being a physician in those circumstances and I am deeply saddened for them, regardless of what actions they did or did not take. Being stuck in a 100+ degree space with rotting corpses and no plumbing sounds like a nightmare enough to send anyone plummeting into insanity but on top of that, that staff was tasked with caring for hundreds of people on little sleep and certainly no true breaks. The mental toll that the staff incurred was immense and this hell lasted approximately 10 days. This comes after Hurricane Ivan stuck the year prior and foreshadowed some potential problems such as electrical issues and flooding on the bottom floors of the hospital yet no changes were made to correct these foreseen hazards. Supplies went quickly and had to be rationed out but then you run into moral dilemma after moral dilemma and that alone put significant stress on the one or ones making the decisions. Some may never step up to the plate and take responsibility for this task which is completely understandable, you are forced to live with the consequences after the event. The physician Anna Pou was doing what she deemed morally, ethically, and logically correct. I mostly agree with what she did, with the information I was presented with, with the exception of Everett, I think he could have survived. I don’t think that from this article alone you can make a truly informed decision but from what info was provided, I think she made the hard decisions others such as Dr. King couldn’t. Pou also did not act alone, many conferred with her or had an inkling as to what was happening and did nothing substantial to stop it. In a situation like that, even if a few cases were unintentional murder instead of mercy killings, the situation these people were presented with would surely make them have clouded judgement and decreased cognitive ability as a whole, there are bound to be mistakes made. The physicians laid to rest the patients in the most humane way – a slumber into cease of respiratory activity into death. As if the situation inside the hospital was not stressful enough, outside the hospital there were numerous reports of assaults, robberies, and rapes making any attempt to leave the hospital horrifying. The hospital itself in disasters such as Katrina become hubs for the community. Those who go there are trying to seek medical attention (new patients were turned away) or loot for supplies. A quote in the article that I found confusing and a little frustrating was Mr. Everett’s wife was when she said, “Who gave them the right to play God? Who gave them the right”. This left me speechless because this woman clearly has no understanding of what doctors do. They play God every day, it is their job to prolong and save lives of people who would have otherwise died. They also are able to decide when treatment is ill-advised and that it is time to let a patient go.
What surprised me most was probably the fact that so many survived. There were so many patients that had been evacuated via helicopter or boat and with the nature of a hospital, the fact so many survived without resources such as their IV’s or respirators before being evacuated is a miracle and a feat. The level of care the teams provided despite seemingly endless adversity and constantly evolving emergencies is incredible. I believe the staff did the best with what they had, they were not perfect and surely made mistakes but I am confident if an entirely different staff had been there, a similar situation unfolded where they need to make decisions about resources and even if the mercy killings were not direct, maybe they would have been left to die, potentially without peaceful passing like the ones that has been laid to rest as tranquilly as possible. Hindsight 20-20 and it’s easy to say “well they could have just done x” or “well they did Y wrong” but all the trainings do not truly prepare you for a real life tragedy and an environment of that nature. I hope that no staff has to experience a situation that horrendous ever again.
The next post is this:
It’s hard to state an overarching “yes or no” to whether or not I agree with the decisions that were made in the hospital since there were so many choices mentioned in the article that were ethically questionable. I think the actions of Dr. Pou had the biggest ethical question mark since they seem to fall under a legal grey area due to the emergency situation she was in. There is no manual for exactly what to do in a situation like that since there is no way to fully predict what is going to happen during a natural disaster. Under normal conditions, what she did would certainly be cause for an investigation, however, these were not normal conditions by any means. The intent behind her actions is unclear, there are conflicting statements between witnesses and Dr. Pou herself. She states that her intent was to make the patients comfortable, but several witnesses heard her mention “lethal doses” of morphine, implying that she intended for them to die. If her intentions were truly to make the patients more comfortable, there is no question that she made the right choice for the well-being of the patients. Another ethically questionable statement mentioned in the article was when Deichmann said that “patients with DNR orders had terminal or irreversible conditions, and at Memorial he believed they should go last because they would have the “least to lose” compared with other patients if calamity struck.”. I see two sides to this, on one hand, as the doctors mentioned, these patients likely wouldn’t want their lives to be prolonged at the expense of others. On the other hand, is it ethical to place a higher value on one person’s life over another? This question seemed to come up several times throughout the article when the authors discussed how the staff had to decide whether they could treat/evacuate someone or not. I believe that in the emergency situation that the doctors were in, they were forced to made decisions like whether one person should be evacuated over another based on their chance of survival. I think this is the best they could’ve done given the circumstances.
Throughout the article, the actions taken, specifically Cook’s, during the aftermath of the storm were extremely shocking to read initially. I don’t agree with the “euthanization of patients”, but aside from that, when considering the emergency situation the hospital was in, it’s hard to say that all of the decisions were heartless or not without reason. When reading the parts where they were unable to accept more patients or give certain patients the care they needed, it seems inhumane, but it doesn’t sound like the staff had much choice. They were low on supplies, lacked power to the hospital, and were mentally and physically exhausted. As I mentioned previously, there was no way to know exactly what the situation was going to be like following Hurricane Katrina. It seems like in the moment, staff and providers were making the decisions they thought were right. I’m sure these were extremely difficult decisions to make and it’s impossible to comprehend what it’s like to be in that scenario. I think this showcases how critical emergency preparedness is; many lives could’ve been saved if there had been a better response plan in place. If the hospital had been better prepared in terms of staff training, supplies, and evacuation procedures, there likely would’ve had a much easier time treating patients.
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